Eldar Bolatovich Baigabatov, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME96344 Issued in FL

Practice address

36 S Main St
Winter Garden, FL 34787-3125

Phone

(407) 347-9886

NPI assigned

Nov 15, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Oct 1, 2022 through Oct 1, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lich Faculty Practice

  • Emergency Medicine Physician
  • Brooklyn, NY
  • NPI 1104018902

  Internal Medicine

  NPD (past)
• Long Island College Hospital

  • Emergency Medicine Physician
  • Brooklyn, NY
  • NPI 1912091828

  Internal Medicine

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419033600000",
    "number": "1104999655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 S MAIN ST",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347873125",
            "telephone_number": "407-347-9886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 S MAIN ST",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347873125",
            "telephone_number": "407-347-9886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAIGABATOV",
        "first_name": "ELDAR",
        "middle_name": "BOLATOVICH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2014-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME96344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa A. Azzizzo
• Ameena Bacchus, PHARM.D.
• Back Aligned Chiropractic, P.a.
• Eugene Paul Bacolod, PTA
• Jenny L Badger, MSPT
• Cheryl Bailey Clemens, LMHC
• Lea Evangeline Baker
• Balanced Podiatry, LLC
• Balanced Wellness Therapeutic Services, Inc.
• Janice Ferlauto Baldo, PT, CLT-LANA

• Internal Medicine Physician in Winter Garden, FL
• Providers in Winter Garden, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.